PONE-D-20-36828

Relationship between diabetes self-care practices and control of periodontal disease among type 2 diabetes patients in Bangladesh

PLOS ONE

Dear Dr. Nakamura,

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Toshiyuki Ojima, M.D., Ph.D

Academic Editor

PLOS ONE

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Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

1. Is the manuscript technically sound, and do the data support the conclusions?

The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented.

Reviewer #1: Yes

Reviewer #2: Yes

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2. Has the statistical analysis been performed appropriately and rigorously?

Reviewer #1: Yes

Reviewer #2: I Don't Know

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3. Have the authors made all data underlying the findings in their manuscript fully available?

The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified.

Reviewer #1: No

Reviewer #2: No

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4. Is the manuscript presented in an intelligible fashion and written in standard English?

PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here.

Reviewer #1: Yes

Reviewer #2: Yes

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5. Review Comments to the Author

Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters)

Reviewer #1: The paper was well written, reporting the prevalence and severity of periodontal disease, analyzing the relative contributions of a wide range of sociodemographic, diabetes self-care practice and oral hygienic factors among patients with type 2 diabetes in Bangladesh.

There are several minor problems need to be clarified.

Page 6, line 96. The exclusion criteria included previously receiving insulin prescriptions. Could you provide the percentage of diabetes patients who have received insulin prescriptions in Bangladesh? And, could you explain the reasons of such exclusion.

Table 1. What the difference between ”all” and “overall”? It’s confusing.

Table 1-3. The sample size for testing any form of periodontal disease was 379, but the sample size for testing the severity of periodontal disease was 287. Please explain the reasons in Methods, and make the columns of the tables more understandable.

For the general population of non-diabetic patients, poor oral hygiene habits are also an important risk factor for early occurrence of periodontal disease. In this study, oral health habits and glycemic control behaviors were put into a model at the same time in patients with diabetes mellitus. The results showed that both the glycemic control behaviors and the oral hygiene behaviors played an independent role in the development and severity of periodontal disease in diabetic patients. Could you further analyze the interaction between these two, and stratify by oral hygiene behavior to see if poor glycemic control is associated with much higher risks of having any forms or severity of periodontal disease among patients with poor oral hygiene?

Reviewer #2: This is a well written manuscript on an important subject area. However, the following suggestions has been made for improving the quality of the paper and better clarification.

Abstract: The second sentence of the Introduction need to be simplified, as it is difficult to understand in the current version. The justification of the second objective “) the relative contributions of selected factors to periodontal disease outcome in type 2 diabetes patients.” should be added.

Results: The Demographics of the participants need to be added (% of male, female, mean age (Standard deviation). The severity % is not clear in the sentence: “The prevalence (75.7%) and severity (35.1%) of periodontal disease were high in type 2 diabetes patients.” The last sentence of the Result “Diabetes conditions and oral hygiene practices explained 10.9% and 7.3% of the variance in severe periodontal disease.” The “severe periodontal disease” is not clear.

Introduction: The last sentence of Page 4 (line 71, 72) Association of periodontal health with self-care practice, healthy diet and physical activity has been shown as a gap in the literature. The potential undying mechanism of these associations need to be indicated to make the rational for investigating this associations. These factors seems to be directly related with the control of diabetes, which can have impact on periodontal health. (similar is the case for Discussion page 22, line 375 and 376. The other potential explanation should be added)

Another point, why it is important to estimate the relative contributions of individual factors to periodontal disease outcome need to be justified (clinical practice related importance etc.)

Results:

The demographic information of the study population need to be included in the first paragraph.

Discussion:

The clinical implication of estimated relative contributions of individual factors to periodontal disease outcome need to be described. Though the tobacco use was not associated for this study population, the suggested comprehensive approach/ model should also include cessation advice along with oral hygiene advice (considering negative impact of tobacco on general health and oral health, specially on periodontitis).

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Reviewer #1: No

Reviewer #2: Yes: Masuma Pervin Mishu

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Relationship between diabetes self-care practices and control of periodontal disease among type 2 diabetes patients in Bangladesh

PONE-D-20-36828R1

Dear Dr. Nakamura,

We’re pleased to inform you that your manuscript has been judged scientifically suitable for publication and will be formally accepted for publication once it meets all outstanding technical requirements.

Within one week, you’ll receive an e-mail detailing the required amendments. When these have been addressed, you’ll receive a formal acceptance letter and your manuscript will be scheduled for publication.

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Kind regards,

Toshiyuki Ojima, M.D., Ph.D

Academic Editor

PLOS ONE

Additional Editor Comments (optional):

Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

1. If the authors have adequately addressed your comments raised in a previous round of review and you feel that this manuscript is now acceptable for publication, you may indicate that here to bypass the “Comments to the Author” section, enter your conflict of interest statement in the “Confidential to Editor” section, and submit your "Accept" recommendation.

Reviewer #1: All comments have been addressed

Reviewer #2: All comments have been addressed

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2. Is the manuscript technically sound, and do the data support the conclusions?

The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented.

Reviewer #1: Yes

Reviewer #2: Yes

**********

3. Has the statistical analysis been performed appropriately and rigorously?

Reviewer #1: Yes

Reviewer #2: I Don't Know

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4. Have the authors made all data underlying the findings in their manuscript fully available?

The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified.

Reviewer #1: Yes

Reviewer #2: Yes

**********

5. Is the manuscript presented in an intelligible fashion and written in standard English?

PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here.

Reviewer #1: Yes

Reviewer #2: Yes

**********

6. Review Comments to the Author

Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters)

Reviewer #1: (No Response)

Reviewer #2: Thanks for addressing the comments. Finally, the manuscript need a careful proofreading. For instance, the last sentence in page 24 (line 496- 461) need to be checked for grammatical correction.

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7. PLOS authors have the option to publish the peer review history of their article (what does this mean?). If published, this will include your full peer review and any attached files.

If you choose “no”, your identity will remain anonymous but your review may still be made public.

Do you want your identity to be public for this peer review? For information about this choice, including consent withdrawal, please see our Privacy Policy.

Reviewer #1: No

Reviewer #2: Yes: Dr. Masuma Pervin Mishu